BOBBY HARRISON: Gov. Bryant takes the ‘liberal’ view of Medicaid powers

By Bobby Harrison/NEMS Daily Journal

Perhaps Phil Bryant is not as conservative as he likes for Mississippi voters to believe. The governor has always referred to himself as a strict constructionist – conservative – when it comes to interpreting the law, and particularly the Constitution.
But maybe that is not the case.
Last week Bryant said that he would attempt to run Medicaid even if the Legislature does not reauthorize or fund the program.
He, in essence, dared anyone to take him to court and stop him, and thus, be responsible for shutting down the state-federal program that provides health care to about 640,000 poor pregnant women, poor children, the disabled and the elderly. Byrant asked if anyone would be willing to go to court and be responsible for shutting down a program that provides nursing home care for thousands of elderly Mississippians.
A lot can happen before the new fiscal year begins on July 1, which is when the program is thrown into chaos unless it receives legislative reauthorization and funding.
Presumably, Bryant will call a special session of the Legislature to tackle the issue before July 1. But he has indicated that he will not unless House Democrats give up on their insistence that a vote be held on the House floor on expanding the program to cover those earning up to 138 percent of the federal poverty level. The federal Patient Protection and Affordable Care Act allows states to expand Medicaid coverage with the federal government paying most of the costs.
Bryant says he opposes the expansion because Mississippi cannot afford its share of the costs, estimated to total more than $800 million by some studies between 2014 and 2020, and because he is against expanding government.
It is estimated that the expansion would provide coverage to about 300,000 Mississippians – primarily the working poor – and create more than 9,000 jobs.
Studies by the nonprofit Kaiser Family Foundation indicate that the federal government will pay about $23 to every $1 by the state for the expansion between 2014-19.
At any rate, the governor, who always likes to be identified as the most conservative guy in the room, is taking an expansive view – or liberal view – of the Constitution in his efforts to oppose Medicaid expansion.
Since ninth-grade civics we all have learned that the legislature controls the purse strings – the power to appropriate and to tax. That is one of the fundamental principles of our representative democracy.
The Mississippi Supreme Court has referred to the Legislature’s control of the purse strings as the “supreme legislative prerogative…” and “is written in express terms or by necessary implications in the constitutions of all free states.”
Suffice to say, if the governor attempts to run Medicaid without legislative action, he will be taking a position that runs contrary to years of basic constitutional separation of powers teachings. Ninth-grade civics teachers across the state will have to rewrite their lesson plan.
Not only would he be spending money not appropriated by the Legislature, but he also would be levying a tax on his own if he intends to run the agency for any length of time.
On July 1, taxes totaling more than $300 million on Mississippi hospitals and nursing homes will stand repealed. To run the agency for any length of time, he would need the revenue generated by those taxes.
Medicaid is an important program to thousands of people. Without it, it is safe to assume that some people would die.
So perhaps Bryant is looking at all the possible outcomes and saying his running the program without legislative authority or funding is the least undesirable of a lot of undesirable possibilities.
But it definitely would not be the strict constructionist or conservative approach when it comes to the Mississippi Constitution.
BOBBY HARRISON is the Daily Journal’s Capitol Bureau chief. Contact him at bobby.harrison@journalinc.com or call (601) 353-3119.